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Original poster

Invoice for prescriptions from an a and e visit

132 replies

scooterbear · 21/01/2022 09:34

I've received a letter this morning from the NHS invoicing me for 5 seperate prescription charges that I incurred during an a and e visit following a serious accident in December-drugs used during my immediate treatment in a and e. When did this become a thing?!
I will obviously pay it (I can just about afford it) and I still recognise that it's immensely good Value considering all the NHS resource I used (ambulance, drs, x ray, scans, etc etc). I was just a bit surprised as I've never heard of this sort of back dated prescription charging before?
What happens to people that need emergency treatment but can't afford the back dated prescription charges?

OP posts:
Fridaynightincreduality · 21/01/2022 12:32

This appears to be the legislation they are quoting on the invoice, in which case if the drugs were administered to you while you were in A & E you are not liable for charges,

Supply of drugs and appliances by Health Authorities, NHS trusts and Primary Care Trusts
5.—(1) A Health Authority, an NHS trust or a Primary Care Trust which supplies to a patient for the purposes of his treatment, drugs, otherwise than for administration at a hospital, or appliances, shall, subject to paragraphs (3) and (4), make and recover from the patient–

There is a later legislation of 2015 but that doesn't seem to rescind this and refers to 'out of hours' services which A& E is not. Really interested in the response you get from the hospital on this.

Georgeskitchen · 21/01/2022 13:07

I wouldn't pay. You need to ask the question why you have been charged.

Missey85 · 21/01/2022 13:17

I'd phone the hospital I've never been charged I had one sent but it was by mistake you shouldn't have to pay it your medicine is free

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Graphista · 21/01/2022 13:19

I'd be thinking this was a scam and calling the hospital to check - by looking up the number for the hospital NOT calling number on the letter! I'd also query with gp.

I have NEVER heard of this and would be very suspicious!

Fatgalslim · 21/01/2022 13:34

@stingofthebutterfly

You should be paying prescription charges for medication administered in A&E, as it's not an inpatient department. Whether they choose to invoice you, or not, is another matter.
I've been in and out of A&E a few times recently, never have I been charged for medication taken whilst there
MadinMarch · 21/01/2022 14:12

I think it's scam
The regulations they quote in the letter say 2000, but in fact the relevant regulation should be 2015, and refers to out of hours services.
www.legislation.gov.uk/uksi/2015/570/regulation/5
I'm not sure whether a&e constitutes an out of hours service though.
I really hope this is not official practise in the NHS now, as charging for a&e treatment would in effect make it a partially private service.
Please take it up OP with the hospital, as it's really important that we all know this is happening, if it turns out to be official practise.

MadinMarch · 21/01/2022 14:14

@Fridaynightincreduality

Sorry, I didn't see that you'd already pointed out the discrepancy in the date of the regulations

Calennig · 21/01/2022 14:19

Look up the hospital PALS number and talk it through with them first.

I'd do this as I don't think it's correct.

Gladioli23 · 21/01/2022 14:20

I think what I don't get about this is there will be loads of instances where people are administered medication while not an inpatient:

If you go to the opthalmology department and they need to use eye drops, or you have a minor operation and they use local anaesthetic, or if you're a cancer patient and you have outpatient chemotherapy, or they always used to dole out ibuprofen/paracetamol while you were waiting to see someone in A and E, or insert any number of examples here!

My assumption is that my care when I am physically in a hospital will be free and I would definitely expect to be warned if it wasn't going to be!

I would not call the number on the letter, but look the hospital number up separately. I'd also be arguing that given you weren't warned in advance that charging you is totally unreasonable, if it's not a scam.

AndSoFinally · 21/01/2022 14:21

Others are right that A&E isn't considered an in patient department so that legislation wouldn't apply.

However, I've never heard of this and would be very cautious about paying. I would expect a proper invoice from the NHS to itemise the medications for a start. The NHS loves a bit of admin so it would seem unusual that they haven't.

BarbaraofSeville · 21/01/2022 14:27

I'm thinking it has to be a scam or a mistake because if someone was being prescribed 5 items that they would end up having to pay for, it's shockingly bad practice to not inform them of the prepayment certificate.

A 3 month one costs about £30, which is less than those five items, plus it would cover what you needed the next day, and anything else you need on prescription for the next 3 months.

monfuseds · 21/01/2022 14:32

I've been in hospital & discharged with a prescription which ive then paid for at the on-site pharmacy. But never for any drugs used during my stay.

RB68 · 21/01/2022 14:34

There is definitely something odd about it. If you can get prescriptions in the hospital normally for the pain, I would be tempted to go in with the letter and ask - if it is a scam they have inside information which the trust would need to know about

I remember reporting an accident and 2 or 3 days later getting weird claim calls, and I called the insurance co and reported it to them as I said only you guys knew about it etc. They denied and denied it and a year later there was a big investigative journalism piece and a number of arrests etc.

So sometimes you get put off querying etc and the reality is they have a bigger problem than they thought and it isn't just an Admin error

BernadetteRostankowskiWolowitz · 21/01/2022 14:39

This is so odd. Definetly find an alternative number to call for your hospital and discuss it with someone.

Nhs provides free care at the point of service. You were administered medication at the point of service - therefore free.

TangfasticsAreFantastic · 21/01/2022 14:42

It's funny that this has come up now as I had a similar trip to A&E recently where they sent me home with a box of painkillers. I had to call the GP a couple of days later and he did a new prescription for me, which I obviously had to pay for. It struck me then that I hadn't paid for a prescription for what I'd brought home with me. If I get a similar invoice, I wouldn't be surprised now.

I'll be a bit annoyed though as the hospital only gave me a box of 30, whereas the gp gave me 100, so the hospital ones will work out 3x the price!

iklboo · 21/01/2022 14:43

This is the section you're being charged under.

NHS CHARGES

Fatgalslim · 21/01/2022 15:03

@TangfasticsAreFantastic

It's funny that this has come up now as I had a similar trip to A&E recently where they sent me home with a box of painkillers. I had to call the GP a couple of days later and he did a new prescription for me, which I obviously had to pay for. It struck me then that I hadn't paid for a prescription for what I'd brought home with me. If I get a similar invoice, I wouldn't be surprised now.

I'll be a bit annoyed though as the hospital only gave me a box of 30, whereas the gp gave me 100, so the hospital ones will work out 3x the price!

But OP is being charged for medication that she was prescribed whilst in A&E, none of it was taken home
Staffy1 · 21/01/2022 15:13

Yep, I got the same from an Essex hospital as well. This was before covid existed.

Gdrykkliijnbxsd · 21/01/2022 15:17

Hospital pharmacist here
I'm not up to date with what is chargeable as I'm in Wales, however this is almost certainly an admin error. Why else would there be 3 letter? We never charged for medicines personally administered by HCPs, whether that was A&E or outpatients, only the medicines taken home from these departments.
I would verify the phone number on the letter then query each invoice

simonisnotme · 21/01/2022 15:20

i think this is a scam!!
Are prescriptions free in hospital?
The aim of the prescription system is simple. It's a flat fee, so that people can afford any necessary medicine regardless of cost. ... All medicines administered by a GP or in hospitals or NHS walk-in centres are free (not if they prescribe you something to take away)
(copied and pasted.)

alexdgr8 · 21/01/2022 15:22

@Soontobe60

www.nhs.uk/nhs-services/prescriptions-and-pharmacies/who-can-get-free-prescriptions/ According to this, you only get free prescriptions if you’re an NHS inpatient. Being in A+E doesn’t mean you’re an inpatient, that only happens if you’re then admitted to hospital. I guess as the NHS is on its knees financially, they have to do whatever they can to claw back spending! I wonder what would happen if someone didn’t pay their invoice?
this is what i was going to say. you were not admitted to the hosp, therefore you were not an in-patient. it's similar for food; waiting in/being treated in A&E, you have to pay for the sandwiches wheeled round, once admitted to a ward, you don't.
Whatdramain2022 · 21/01/2022 15:27

Years ago I was working in an A&E, but in my own separate department. I was located in A&E. I remember a big poster on the wall saying that patients had to pay for any drugs administered from injuries from an accident. Medical emergencies weren't charged, only accidents. I'm in England.

SoupDragon · 21/01/2022 15:33

The regulations mentioned (apart from be 2015 rather than 2000) say:

(8) Nothing in this regulation authorises the payment of a charge where the drug or appliance supplied is either—

(a)needed for immediate treatment and no order for the drug or appliance is made on an approved form; or

(b)administered or applied to the patient by the provider of out of hours services personally.

So, as the drugs were needed for immediate treatment and were administered by A&E it seems like you don't have to pay. It could just be and in error in that they think you took the drive away.

alexdgr8 · 21/01/2022 15:38

i think they are entitled to charge you.
it may be that most trusts don't, just as they used not to pursue overseas' patients for in-patient treatment costs, but now they do.
other people from harlow area have stated that they have experienced this.
i think it will become more widespread.
just as all trusts now have an overseas dept for recouping costs from overseas' patients. in the past they didn't bother, or thought it cost too much to administer. now every penny is pursued.

Poshjock · 21/01/2022 15:45

@SoupDragon

The regulations mentioned (apart from be 2015 rather than 2000) say:

(8) Nothing in this regulation authorises the payment of a charge where the drug or appliance supplied is either—

(a)needed for immediate treatment and no order for the drug or appliance is made on an approved form; or

(b)administered or applied to the patient by the provider of out of hours services personally.

So, as the drugs were needed for immediate treatment and were administered by A&E it seems like you don't have to pay. It could just be and in error in that they think you took the drive away.

Yes this

Whatever you were given as part of your treatment whilst you were in the department, you CANNOT be charged for. What you were given to take home, you can.

As you already paid for the stuff you took home, you need to query this as it’s an error.

This is written in the very regulations they quote on their letter.